Vertigo & Vestibular Therapy

What is Vertigo?

Vertigo is a symptom that you can experience which creates a sensation that the room around you is spinning or moving. It can range from being barely noticeable to extremely severe making it difficult to complete normal everyday tasks. Some people experience dizziness and attribute that to having vertigo but, if you do not have the sensation of the room around you moving/spinning you do not have vertigo.

What Causes Vertigo and Other Vestibular Problems?

The inner ear contains one of the major balance systems in our body. Sometimes, when the crystals in the inner ear have moved to a place where they are not supposed to be, you can experience severe vertigo (spinning of yourself or the room).

There are other vestibular problems such as the one produced in the vestibulocochlear nerve, which is located in the inner ear and is used to send balance and head positioning information to the brain. When this nerve becomes swollen the brain cannot interpret the information being passed to it and this results in dizziness and vertigo symptoms to occur.

Diagram of the Inner Ear

Diagram of the Inner Ear

Are There Different Kinds of Vestibular Disorders?

Yes! There are many different kinds of vestibular disorders with Benign Paroxysmal Positional Vertigo (BPPV) being the most common one. Some vestibular disorders are:

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Cervicogenic Dizziness
  • Central Positional Vertigo
  • Persistent postural perceptual dizziness (PPPD)
  • General Vestibulopathy

Vestibular issues can result from a multitude of reasons, some being:

  • Side effects to medication
  • Head trauma + brain related issues
  • Inner ear issues, infections, tumours (ex: Labyrinthitis, Vestibular Neuritis, Acoustic Neuroma)
  • Diseases (ex: Ménière’s Disease, Autoimmune Inner Ear Disease)
  • Age-related dizziness and imbalance
Woman with vertigo sitting and leaning against wall

Benign Paroxysmal Positional Vertigo (BPPV) is the most common cause of vertigo. It is a problem residing in the inner ear which causes a false sense of spinning, or the room to be moving.

BPPV occurs when tiny calcium crystals called otoconia come loose from their normal location in the ear.

If the crystals become detached, they can flow freely in the fluid-filled spaces of the ear. Vestibular therapy and specific repositioning maneuvers can be used to move these crystals back to where they are supposed to be, which is on the utricle, a sensory organ in the inner ear.

Cervicogenic dizziness is a feeling of disorientation or unsteadiness which is created from tension in the neck and upper shoulder area. This condition is almost always accompanied by neck pain, headaches, and a limited range of motion in the neck.

Treatment of the neck problem can help with cervicogenic dizziness to go away as well as receiving vestibular therapy.

woman experiencing dizziness / vertigo

How Do I Know if  I Need Vestibular Therapy?

Ultimately, you should be possessing some of the symptoms associated with Benign Paroxysmal Positional Vertigo (BBPV), or cervicogenic dizziness which is created from tension in the neck and upper shoulder area.


  • Room spinning,
  • Unsteadiness,
  • Visual issues,
  • Nausea including vomiting,
  • Headaches,
  • Fatigue
  • Poor concentration

How Does Vestibular Therapy Work?

During your initial assessment, your physiotherapist will discuss with you your history and the nature of your symptoms. They will also perform various tests such as evaluation of eye movements, sensitivity to motion or position change, and evaluation of stationary or moving balance. The main test our physiotherapists use to detect BPPV is called the Dix-Hallpike maneuver.

After you have been diagnosed with Vertigo our physiotherapists will use a repositioning maneuver called the Epley maneuver. It involves holding certain positions for up to 30 seconds at a time (or until symptoms dissipate), before moving onto the next one. The goal of these maneuvers is to get the tiny bio-crystals (Otoconia) in your ears to move out of the semicircular canals of your inner ear and into the correct positions they once were in.

Although it is a relatively quick treatment, we always require our patients receiving vestibular therapy to have someone drive them to and from their appointments, as there will be an increase in symptoms for a short while from the maneuvers, but the relief afterward is often dramatic.

Is This Treatment Effective?

Vestibular therapy treatment has proven to be very successful due to its quick symptom decrease and short amount of sessions needed.

How Long Does it Take to See Improvements?

Our physiotherapists normally recommend only 2 – 3 sessions of vestibular therapy treatment. In these few sessions, our therapists will also provide at-home care with different exercises and techniques that can be done by yourself to further help you improve your vestibular conditions.

How Much Does it Cost?

Our private vestibular therapy sessions are $100 per session and can be directly billed to most major extended health coverages. If you are coming in due to a motor vehicle accident there may be coverage for you for vestibular therapy sessions under ICBC. Once assessed, our therapist can fill out a form requesting you be approved for this type of treatment.  

Take the next steps to feeling better…

If you have questions about whether this treatment is right for you please give us a call (604) 474-1276

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